Vertical dimension is a compounding problem.
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Biomedical subjects
Publications and source records attributed to T D Creekmore.
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Frequently, the anticipated results of treatment are not achieved by using preadjusted appliances and straight wires. This is due to inaccurate bracket placement, variations in tooth structure, variations in the maxillary/mandibular relationships, tissue rebound, and mechanical deficiencies of edgewise orthodontic appliances. Clearly, one preadjusted appliance prescription cannot fit all orthodontic patients. Individualized prescriptions for preadjusted orthodontic appliances can be fabricated once all of these reasons are recognized. From the cephalogram and visual treatment objective, the desired position of maxillary and mandibular incisors can be determined according to the maxillary/mandibular relationships. The torque angle of the labial surface of maxillary and mandibular incisors relative to the arch wire plane can be measured with an incisor torque template. The development and refinement of a system to vary the orientation of the bracket arch wire slot relative to the labial surface of each tooth provides a solution to these problems. Beyond the accuracy or inaccuracy of bracket placement and the fact that brackets are placed away from the center of resistance, orthodontic appliances have two additional significant mechanical deficiencies; play between the arch wire and the arch wire slot, and force diminution. These deficiencies cannot be eliminated from current appliances, however, they can be minimized by using reasonably stiff arch wires approximating the size of the arch wire slots. The amount of play plus the amount of force diminution inherent in your appliance can be added to or subtracted from the torque, tip, rotation, and height parameters for each bracket to deliver the teeth to the desired positions. Therefore treatment goals can be achieved with maximum efficiency.
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The combined efforts of different specialists are needed for the successful treatment of patients with the long face syndrome. Both surgeons and orthodontists who recognize their own capabilities and limitations must combine their skills to achieve the best possible occlusion and facial esthetics. The surgical and orthodontic plan of therapy is designed to correct the patient's dentofacial deformity. Surgical reduction of facial height and proper alignment of the teeth by orthodontic means are common denominators of successful treatment. By properly planned and executed Le Fort I maxillary osteotomies, the vertical dimensions of the face can be shortened to improve the esthetic balance between the nose, upper lip, teeth, and chin and achieve lip competency. Variable open-bite and nonopen-bite maxillary deformities in forty adults with the long face syndrome were corrected by Le Fort I osteotomy and orthodontic treatment. The technical problems encountered in planning and executing treatment are discussed and illustrated by selected case reports.
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